Permit Il gi
lq Community Development SEP 2 7 2011
TIGARD Request for Permit Action �' ,� ,`.‘`� r � ;L %,�
TO: CITY OF TIGARD
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor Zi City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) V 1 .. 1 6 E Lecria 1 c, l 1-)c-- Mailing Address: b`JDq ' -e._ AST
City/State /Zip: P02T(, A 1Yj 02. 7 a 1 6
Phone No.: 5o3" 9.05-'ga -78
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED ( ✓):
I_ CANCEL PERMIT APPLICATION.
• REFUND PERMIT FEES (attach receipt, if available).
INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: i tkC ~ Do A6
n I `
Site Address or Parcel #: i (0 �d W p - 1•} AID !4-1{ u5 -T
Project Name: L0/36 b1--4 F 00/Jl X
Subdivision Name: L #: -lfc
EXPLANATION: ExPtati PE2. - t PER - 64iLatt■ 1 e.0 ()t,c11 -L.
Signature: ., Date: 9
1
,, . 9-7 (r/
Print Name: – IDS/ 1 )6 1 E 1� R. P{-t -M 64`t
Refund Policy
I The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits pnor to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to S s Admin: Date 4 Egranommi Rte to Bld: Admin: Date Ae B
Refund Processed: Date N ° By d.NI Invoice Processed: Date By
Permit Canceled: Date2 / /� By j r arcel Tag Added: Date By
Receipt # Date Me od Amount $
I. \ Building \ Forms \Regl'cmutAction.doc Rev 07/26/07
• i' I .,EIVED EXPIRED a////d-
Electrical Permit Application MAY 2 7 2009
City of Tigard Received
^ ^�
Date/Hy: 5 o'Z 7 � � �C..� �00 ^ C.G%1 0�.
u 13125 SW Itall Blvd , Tigard, OR 97i 1'Y ING DIVISION OFTIGARD Plait Re\iew r
Nowt No �^1
Phone: 503.639.4171 Fax: 503. Datr 71 ( �/ 4— � Other Permit.
I' I A R 1 Inspection Line: 503.639.4175 Date Ready /Iiy: , ho iii See Page 2 for
Internet: www.tigard- or.gov Notified od• (a M 4 ' Supplemental Information
TYPE OF WORK : -- :. `r" (/i w all o,p PLAN REVIEW
® New construction ❑ Addition /alteration/replacement ` Please the that apply (submit,' sets of plans w/stems checked below)
® Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑Other:
where the available fault current ❑ Marinas and boatyards
CATEGORY OF - CONSTRUCTION - . . • exceeds 10.000 amps at 150 volts or ❑ Floating buildings
less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings
® Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or • JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new• motor load of
Job no.: Job site address: 5 f1&Mandamus Ct 1001 1P or more occupancy.
Six or more residential units ❑Recreational vehicle parks
City /State/ZIP. Tigard, OR 97223 ❑ 1lealth -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 sobs nominal
Suite/bldg. /apt. no.: 4 I Project name: Longstaff Condos ❑ Service or (ceder 600 amps or more
FEE SCHEDULE
Cross street /directions to job site: Description
I Qty. I Vet. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33 40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK • . (with above sq. II ) 75.00 2
Limited energy, multi - family
Electrical Service, wiring and low voltage residential (with abuse sy 0 ) 75 00 2
Services or feeders installation, alteration, and /or relocation
_ 200 amps or less 6 80.30 'lg / 2
® PROPERTY OWNER • ❑ 'I'F :NAN1' 201 amps to 400 amps 106.85 2
Name: Brownstone at Lincoln Park, LLC 401 amps to 600 amps 160.60 2
601 amps to 1.000 amps 240.60 2
Address: 7050 SW Clinton Street Over 1,000 amps or volts 454.65 2
City /State /ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 -30 2
intended for sale, lease. rent, or exchange, according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A Fee for branch circuits with
❑ APPLICANT - I )21 CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: RCM Homes, Inc. H. Fee for branch circuits
without service or feeder fee,
Contact name: Ron Lightner 46 85 2
first branch circuit
Address: 7050 SW Clinton Street Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97223 Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: (503) 598 - 7565 x 101 Fax: : ( ) Reconnect only 66 85 2
E -mail: rlightnertg?brownstonehomes.net Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Dms Electric, Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 8504 SE Stark ST extension. Describe: Page 2 2
City/State/ZIP: Portland, OR 97216 Each additional inspection over allowable in any of the above
I'cr inspection 62.50
Phone: (503) 209-9298 Fax: (503) 252 -6611
Investigation per hour (I hr min) 62 50
(:('B Lie.: 118073 Electrical Lie.. 3 742C v. I.ic.: 4542 S Industrial plant per hour 73.75
/ ELEC1'RI(:AL PERMIT FEES
Suprv. Electrician signature. required: _ Subtotal: V8(- So
Print name: Vacile Petri! Date: 5/26/2009 Plan review (25% of permit fee }' /9 . ‘15"
1 111111Draf-�anill■-. State surcharge (12% of permit fee): 5 g't
signature: ` ~■�
Authorized si
I; . _ TOTAL PERMIT FEE: 6, 0
-
Print name: Paul Grushevskiy Date: 5 /26/2009 This permit application expires if a permit is not obtained within 180
Jays after it has been accepted as complete.
• Number of inspections allowed per permit
I iaeildmg Permits'L•LC- PermiiApp doc 0:23/06 440.461 'Ot,c()Nitm I-H
JUL-16-2009 12'09 From: To: 503598,1960 P.3'7
Electrical Permit Application
city of Tigard
E \0:. c onstruLtion ID Addition alit rail, tri.. rep I at,e mem V .■te • bmI 11! il..ti IN; v ■ Numov ; orl, 1$1 Om, ■% Oa,: clu:Lkdt•1:1:0, ..
Joh no 12 site addrrS 97(1 SM Mandamus (.2
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• • •• •• • • • • •
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Contractor DMS Electric, Inc Supr. Electr. Vacily Petrila
8504 SE Stark St Lic # 4542S • . • • • • .
Portland, OR 97216 • • •• • • • • • • i • i i • i
• • • • • • • • • ••
• • • • • • • • •
• • • ••• • ••
Project: Longstaff Rev . 4/26/2009
Building: Bldgs 1, 2, 4 - 8
••• ••• • • •• •• •
• Unit Type A Sq. Ft. 833 x # of units 2 x VA; ;•; ••41V$ VS/aSts
Unit Type B1 Sq. Ft. 1039 x # of units 2 x 3 VA* • • t2 1 34 1 Watts
Unit Type B2 Sq. Ft. 1163 x # of units 2 x 3 VA = 6978 Watts
Unit Type Sq Ft. x # of units 0 x 3 VA = 0 Watts
Unit Type Sq. Ft. x # of units 0 x 3 VA = 0 Watts
Unit Type Sq. Ft. x # of units 0 x 3 VA = 0 Watts
Total 18210
Appliance 3,000 x # of units 6 = 18000 Watts
Laundry 1,500 x # of units 6 = 9000 Watts
Dishwasher 1,200 x # of units 6 = 7200 Watts
Disposal 850 x # of units 6 = 5100 Watts
Micro /Hood 1,250 x # of units 6 = 7500 Watts
Gas Furnace 1,500 x # of units 0 = 0 Watts
Range 10,200 x # of units 6 = 61200 Watts
Dryer 5,000 x # of units 6 = 30000 Watts
Water Htr. 4,500 x # of units 6 = 27000 Watts
House panel 0 0 Watts
Total 165000
Heat or AC (Largest Load)
Unit Type A VA 6000 x # of units 2 = 12000 Watts
Unit Type B1 VA 6000 x # of units 2 = 12000 Watts
Unit Type B2 VA 6000 x # of units 2 = 12000 Watts
Unit Type • VA x # of units = 0 Watts
Unit Type VA x # of units = 0 Watts
Unit Type VA x # of units = 0 Watts
Total 36000
Load Subtotal 219210
Demand at 44%
Demand Load 96452.4
Misc Load CITY OF TIGARD
Total Load 96452.4 Approved rxj
240 V Conditionally Approved [ j
See Letter to: Follow [ i
PHASE 402 AMPS Attached i j
Permit Number: E LC, zoo •00 L SZ-
Address: S 3 4 (• S W MPil DA M 01
By: Cr , Lr 4V. Date: b • ?-f 09'
OFFICE COPY EXP R
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PGE • • • • • • • • • • . • •
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9480 SW Boeckman Rd.
Wilsonville, OR. 97070 • • • • • • • • • • •
•
• .
• •.. ••. •• • •
May 6, 2009 • • • • •
Paul Grushevskiy
Operations Manager
Dms Electric, Inc.
8504 SE Stark St
Portland, OR 97216 •
RE: Longstaff Condos — PGE WR# 432410
Below please find the Maximum Fault Currents for the buildings in this phase of the
project. All fault currents are calculated for 120/240 Single Phase Voltage.
Building No. Panel Size* Maximum Fault Current (Amps)
1 600 Amp 8,715
2 600 Amp 9,198
3 200 Amp 7,579
4 600 Amp 11,189
5 600 Amp 11,904
6 600 Amp 8,577
7 600 Amp 7,105
8 600 Amp 10,701
* As provided by customer.
If you have any questions, please call me at 503 - 570 -4407.
Thank you,
Lorraine Katz
PGE Service & Design
Wilsonville Line Crew Center
9480 SW Boeckman Rd. CITY OF TIGAR D
Wilsonville, OR 97070 Approved [xj
Conditionally Approved [
See Letter to: Follow [
Attached [ ]
Permit Number:
Address:
By: Date:
OFFICE COPY